Depression is a genuine illness

Editor’s note: Dr. Paul Donohue’s column, long a popular feature in the Sarasota Herald-Tribune, now has an online home, as well. Check out the medical questions and answers Mondays through Fridays on Health + Fitness. CLICK HERE TO READ MORE DR. DONOHUE COLUMNS.

DEAR DR. DONOHUE: I have been on Paxil for a number of years due to an unfortunate happening in my life. It has now been more than 15 years.

Dr. Donohue

I'm an elderly person. I take other prescription drugs for high blood pressure and gastric reflux, and aspirin for my heart.

Would it be safe for me to wean myself from Paxil at this phase of my life? -- J.M.

ANSWER: It would be safe to do so if you get the go-ahead from the doctor prescribing Paxil for you.

Depression is a common illness that affects one out of five people at one time or more during their lives. It's not the ordinary sadness that people feel when misfortune strikes. It's something that often strikes out of the blue and lasts for what seems like an eternity. It robs people of all the joys of life. Depressed people find it hard to get to sleep or to stay asleep. Appetite goes. Interest in friends and hobbies vanishes. Sexual feelings disappear. Anxiety almost always goes hand in hand with depression. It's an illness much like other medical illnesses. President Abraham Lincoln suffered two major depressions in his life before he became president. Faithful friends helped him get over these downturns.

Medicines are part of depression treatment. For a first depression, the medicine is continued for nine months or longer. For people who have had recurring depression or a severe first depression, the length of therapy is longer, and in some cases lifelong.

This illness has been attributed to a "chemical imbalance." The imbalance has to do with the production of brain chemicals by which brain cells communicate with each other. These chemicals have names such as serotonin, norepinephrine and dopamine. Recently, the theory of chemical imbalance has been challenged, but the use of antidepressant medicines is still in vogue.

Your doctor will give you a schedule of reducing your dose of Paxil until you are finally off it.

DEAR DR. DONOHUE: Please send me information on the eyes. I was told I have cataracts. -- D.F.

ANSWER: If you're older than 65, you belong to a population of which half the people have the beginnings of a cataract. If you're over 75, you belong to a population of people of which 70 percent have the beginnings of a cataract.

Cataracts come with aging. Usually, they progress slowly. Most people don't need to have surgical removal of the cataract. They do quite well without any medical interference.

The time to remove a cataract is the time when it blurs your vision. That's the time you will want treatment and your doctor will recommend it. Removing a cataract these days is a far cry from what it used to be only a few decades ago. The patient returns home shortly after the cataract is removed, and is up and about the next day.

ANSWER: You're asking the wrong person about peanut butter. I love it. I could live on it.

On average, 2 tablespoons of chunky peanut butter has 190 calories with 17 grams of fat. Of that fat, 13.5 grams are polyunsaturated fat, good fat, not the kind of fat that clogs arteries. It has no cholesterol. It has 140 mg of sodium (salt), not an exorbitant amount.

I don't think you need to give it up. It's not a health threat.

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Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

Dr. Donohue

Dr. Paul Donohue writes a daily column titled "To Your Health" that is syndicated to more than 175 newspapers. The question-and-answer series is one of the oldest health columns in the North America, having first appeared in the 50s. Dr. Donohue took over the series nearly 20 years ago. Dr. Donohue is board-certified in his primary specialty, internal medicine, the specialty that emphasizes diagnosis and non-surgical treatment of illnesses. He also is board-certified in the subspecialty of infectious diseases. He graduated from the University of Michigan Medical School in Ann Arbor, Michigan. He has a master's degree in public health from Tulane University in New Orleans and did advanced work on infectious diseases at the University of California, Davis. After completing medical school, he served two years in the Army Medical Corps and 18 months as battalion surgeon in the 173rd Airborne Brigade-for which he was awarded two Bronze Stars, one of which was for valor during combat. Write to Dr. Paul Donohue at P.O. Box 536475, Orlando, FL 32853-6475.

Last modified: May 12, 2012
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